Elizabeth C. Ahern & Thomas D. Lyon Publisher: Routledge

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University of Southern California Law
From the SelectedWorks of Thomas D. Lyon
September, 2013
30. Facilitating maltreated children's use of
emotional language.
Elizabeth C. Ahern,University of Cambridge
Thomas D. Lyon,University of Southern California
Available at:http://works.bepress.com/thomaslyon/86/
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Journal of Forensic Social Work
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Facilitating Maltreated Children's Use of
Emotional Language
Elizabeth C. Ahern a & Thomas D. Lyon b
a Department of Psychology , University of Cambridge
b University of Southern California, Gould School of Law
Published online: 27 Nov 2013.
To cite this article: Elizabeth C. Ahern & Thomas D. Lyon (2013) Facilitating Maltreated
Children's Use of Emotional Language, Journal of Forensic Social Work, 3:2, 176-203, DOI:
10.1080/1936928X.2013.854124
To link to this article: http://dx.doi.org/10.1080/1936928X.2013.854124
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Journal of Forensic Social Work, 3:176–203, 2013
Copyright © Taylor & Francis Group, LLC
ISSN: 1936-928X print/1936-9298 online
DOI: 10.1080/1936928X.2013.854124
Facilitating Maltreated Children’s
Use of Emotional Language
4
1
0 ELIZABETH C. AHERN
2
y
ar Department of Psychology, University of Cambridge
u
r
b THOMAS D. LYON
e
F
4 University of Southern California, Gould School of Law
0
7
3
9:
0
at This study examined the effects of rapport (emotional, National
e] Institute of Child Health and Human Development [NICHD]) and
u
q prompt type (what-next, cued-action, cued-emotion, what-think)
a
J
a on one hundred forty-two 4–9-year-old maltreated children’s
n
Dia spontaneous and prompted emotional language. Children in the
], [ emotional-rapport condition narrated the last time they felt good
nia and the last time they felt bad on the playground. Children in the
r
o NICHD-rapport condition narrated their last birthday party and
f
ali what happened yesterday. Following rapport, all children were
C
n presented a series of story stems about positive and negative
r
e
h situations. Emotional-rapport minimally affected children’s use of
ut
o emotional language. Cued-emotion prompts were most productive
S
f in eliciting emotional language. Overall, there were few effects
o
y because of age. Children often produced less emotional language
sit
r when describing negative events, particularly with respect to their
e
v
ni spontaneous utterances, suggesting reluctance. These differences
U
C largely disappeared when children were asked additional questions,
S particularly cued-emotion questions. The results offer support for
U
y [ cued-emotion prompts as a means of increasing maltreated
b
d children’s use of emotional language.
e
d
a
o
nl
w
o
D When describing abuse in forensic contexts, many children do not mention
the emotional impact of abuse (Lamb et al., 1997; Lyon, Scurich, Choi, &
Handmaker, 2012; Westcott & Kynan, 2004) and most do not appear visually
Address correspondence to Elizabeth C. Ahern, University of Cambridge, Department of
Psychology, Free School Lane, Cambridge CB2 3RQ UK. E-mail: [email protected].
176
Facilitating Emotional Language 177
upset (Gray, 1993; Sayfan, Mitchell, Goodman, Eisen, & Qin, 2008). The lack
of emotional information children provide fails to reflect the emotional
impact of abuse (Putnam, 2003) and may compromise the perceived credi-
bility of children’s allegations (e.g., Myers et al., 1999; Coy v. Iowa, 1988).
The purpose of the present study was to examine means to increase
maltreated children’s use of emotional language. We focused on two major
questions: Can the rapport phase of the forensic interview be manipulated to
4 facilitate children’s emotional language? Can prompts referencing emotional
1
0 content increase children’s emotional language? To address these questions,
2
y we examined two interviewing interventions: emotional rapport, in which
r
a
u children were asked to narrate positive and negative events, and cued-emo-
r
b
e tion prompts, in which children were asked to elaborate on emotions.
F
4 Only a few studies have examined the emotional content children men-
0
7 tion when describing past events, showing that children’s emotional report-
3
9: ing is infrequent and brief (Sales, Fivush, & Peterson, 2003; Walton, Harris, &
0
at Davidson, 2009). On average, children mention zero to four emotion words
]
e per narrative (Butler, Gross, & Hayne, 1995; Fivush, Sales, & Bohanek, 2008).
u
q
a Most studies report no age differences despite wide age ranges, indicating
J
a that older children report as few emotion words as preschoolers (Ackil, Van
n
a
Di Abbema, & Bauer, 2003; Fivush, Hazzard, Sales, Sarfati, & Brown, 2003).
[
], Studies on maltreated populations show that many children fail to describe
a
ni their subjective reactions to abuse in investigative interviews (Lamb et al.,
r
o 1997 [51%]; Westcott & Kynan, 2004 [80%]).
f
ali
C
n
r
e
h WHY DON’T MALTREATED CHILDREN
ut
o SPONTANEOUSLY USE EMOTIONAL LANGUAGE?
S
f
o
y
sit Researchers have claimed that children’s capabilities to express their
er emotions are deficient (Aldridge & Wood, 1998) and interviewers are
v
ni sometimes cautioned not to ask maltreated children about emotional
U
C reactions to abuse because such questions may make children appear
S
U incompetent (Aldridge, 1997). However, laboratory and observational
[
y studies attest to children’s early abilities to understand and verbalize emo-
b
d tions (e.g., Lagattuta & Wellman, 2001; Peng, Johnson, Pollock, & Harris,
e
ad 1992; Schleien, Ross, & Ross, 2010). Research suggesting deficiencies in
o
nl maltreated children’s emotional understanding (Camras, Sachs-Alter, &
w
o Ribordy, 1990) can be challenged; maltreated children equal their non-
D
maltreated peers when simplified versions of laboratory tasks are used
(Smith & Walden, 2001; Sullivan et al., 1995). Evidence from the field
shows that maltreated children can use a sophisticated range of emo-
tional reactions when describing their feelings surrounding abuse (e.g.,
Berliner & Conte, 1990; Lyon, Scurich, Choi, Handmaker, & Blank, 2012;
Sas & Cunningham, 1995).
178 E. C. Ahern and T. D. Lyon
Children’s failure to report negative emotions may be due to reluctance
rather than inability, especially when they are reporting traumatic events.
Children who experience high degrees of anxiety surrounding the target event
use less emotional language in their verbal reports than children who experi-
ence less anxiety (e.g., Greenhoot, Johnson, & McCloskey, 2005; Peterson &
Biggs, 1998; Wolitzky, Fivush, Zimand, Hodges, & Rothbaum, 2005).
Maltreatment exposure may also contribute to children’s reluctance to
4 report emotional information (Sayfan et al., 2008). Maltreated children learn
1
0 that negative expressions of emotions can cause harm to themselves or others
2
y (Briere, 1992; Cole, Zahn-Waxler, & Smith, 1994), they often use coping strate-
r
a
u gies that reduce emotional awareness, and they do not endorse open nega-
r
b
e tive affective displays (Briere, 1992; Harter, 1998; Shipman & Zeman, 2001).
F
4
0
7
3
9: RAPPORT PHASE IN INTERVIEWS AND
0
at EMOTIONAL LANGUAGE
]
e
u
q
a The rapport phase of child interviews includes questions children initially
J
a receive to establish comfort with the interviewer before being asked about
n
a
Di the target event (Walker & Warren, 1995). Most child autobiographical stud-
[
], ies do not include practice narratives during the rapport phase (e.g., Fivush
a
ni et al., 2003; Baker-Ward, Eaton, & Banks, 2005), which may have decreased
r
o children’s ability to report emotional information. In contrast, field and labo-
f
ali ratory research using the National Institute of Child Health and Human
C
n Development (NICHD) structured interview illustrates that children can be
r
e
h trained to provide lengthy narratives when they participate in episodic
ut
o memory training during the rapport phase (Hershkowitz, 2009; Sternberg et al.,
S
of 1997; Roberts, Lamb, & Sternberg, 2004). During the NICHD rapport phase,
y
sit the interviewer first explores the child’s likes and dislikes, and then uses
er episodic memory training to familiarize children with open-ended prompts
v
ni and demonstrate the level of detail expected of them (Orbach et al., 2000).
U
C No research has examined children’s emotional productivity when
S
U questioned using the NICHD structured interview or the potential for modi-
[
y fying the interview as a means to increase emotional productivity. The
b
d NICHD rapport phase asks children to recall past events without cuing chil-
e
ad dren to the emotional significance of the events. The NICHD events include
o
nl children’s birthdays and what happened yesterday. In the present study, we
w
o assessed emotional rapport, which asked children to recall explicitly emo-
D
tional events. Emotional events included the last time children “felt good”
and the last time children “felt bad.” Other research has used these types of
cues to elicit narratives about positive and negative events from children
(Marin, Bohanek, & Fivush, 2008). Because NICHD rapport events do not
explicitly cue children to the emotionality of events, we anticipated that
emotional rapport would increase emotional language.
Facilitating Emotional Language 179
PROMPT TYPE
Another factor that may influence children’s emotional productivity is the
type of prompt used to elicit additional information. The extent to which
children did not provide emotional information in child autobiographical
studies may be due to nonproficient use of open-ended prompts by inter-
viewers. The child autobiographical studies do not report the number or
4 type of prompts used to maximize free recall (Baker-Ward et al., 2005; Fivush
1
0 et al., 2003). In field studies with maltreated children, open-ended prompts
2
y elicited longer responses than closed-ended prompts (Lamb, Hershkowitz,
r
a
u Orbch, & Esplin, 2008; Lamb, Orbach, Hershkowitz, Esplin, & Horowitz,
r
b
e 2007). Thus, the extent to which children received closed-ended rather than
F
4 open-ended prompts may have reduced children’s general productivity.
0
7 In the NICHD structured interview, children’s initial responses are
3
9: followed up with cued-invitations (e.g., “You said you [walked]. Tell me more
0
at about that.”) (Orbach et al., 2000). In contrast, prompts used in many of the
]
e autobiographical studies may have been excessively vague, such as “tell me
u
q
a more about that” (Hamond & Fivush, 1991), when the term “that” may have
J
na been unclear (Walker, 1993), or “tell me more” (Fivush et al., 2003), when the
a
Di topic of what to “tell more” about was unspecified (Hershkowitz, 2001).
[
], Because children tend to focus on outcomes and actions (Bruchkowsky,
a
ni 1992; Goldberg-Reitman, 1992; Griffin, 1995), they may need to be cued to
r
fo provide emotional content. In court testimony and in forensic interviews
Cali about abuse, prompts specifically referencing emotion were more likely to
n elicit emotional content, and the most productive prompts were more open-
r
e
h ended (Lyon et al., 2012). Moreover, the revised NICHD Protocol includes
ut
o prompts encouraging children to expand on their references to emotion
S
of (Hershkowitz et al., in press). We anticipated that questions that asked chil-
y
sit dren to elaborate on emotional information would be particularly productive
er in eliciting additional emotional language.
v
ni However, it is possible that asking children about their emotions may
U
C have negative effects. Inquiry into negative emotions during rapport may
S
U increase reluctance by highlighting children’s discomfort and thus compro-
[
y mise children’s verbal productivity and comfort with the interviewer (Murray,
b
d Lamnin, & Carver, 1989). This may be especially relevant at the end of rap-
e
ad port building when children’s trust and cooperation with the interviewer
o
nl should peak before transitioning into the allegation (Hershkowitz, Orbach,
w
o Lamb, Sternberg, & Horowitz, 2006).
D
CURRENT STUDY
The research goal was to examine two interviewing methods to increase
maltreated children’s use of emotional language: emotional rapport and
180 E. C. Ahern and T. D. Lyon
prompts. One hundred forty-two 4- to 9-year-old maltreated children
participated in either the NICHD-rapport condition or the emotional-rapport
condition and were asked a series of open-ended prompts. The age groups
consisted of preschoolers (4- to 5-year-olds), early elementary school (6- to
7-year-olds), and young preadolescents (8- to 9-year-olds). This age range was
selected because 4 years of age is the youngest age at which open-ended
invitations elicit more information from children in forensic interviews (e.g.,
4 Lamb et al., 2003) and because studies suggest substantial changes in children’s
1
0 understanding of emotion during the early school years (Harris, 1983; Peng
2
y et al., 1992). All children participated in interview instructions (e.g., permission
r
a
u to say “I don’t know”) and an icebreaker phase (e.g., “tell me about things you
r
b
e like to do”, “tell me about things you do not like to do”) adapted from the
F
4 NICHD Protocol. Children in the NICHD-rapport condition were asked to
0
7 describe what happened on their last birthday and what happened yesterday.
3
9: Children in the emotional-rapport condition were asked to describe what
0
at happened the last time they “felt good” on the playground followed by the
]
e last time they “felt bad” on the playground. Emotional rapport focused on
u
q
a playground experiences to prevent children from potentially making disclosures
J
a of maltreatment. In both rapport conditions, children’s emotional utterances
n
a
Di were followed up with cued-emotion (“You said [emotion]. Tell me more about
[
], that”) and what-think prompts (“What did you think when [emotion]?”).
a
ni Following rapport, children completed story stems about events eliciting
r
o positive or negative outcomes for protagonists. Similar to the rapport phase,
f
ali all children were asked what-next, cued-action, and cued-emotion prompts
C
n to the stories. The negative stories were adapted from the MacArthur Story-
r
e
h Stem Battery (Bretherton, Oppenheim, Buchsbaum, Emde, & the MacArthur
ut
o Narrative Group, 1990) which have been used to assess maltreated children’s
S
of narratives containing conflictual and moral themes (Toth et al., 2000; Macfie
y
sit et al., 1999; Toth, Cicchetti, Macfie, & Emde,1997). The positive stories were
er developed by the authors and included the same number of characters,
v
ni objects, verbs, nouns and adjectives as the negative stories. Although
U
C traditional use of story stems involve props, none were used in the present
S
U study because prop use in abuse investigations is controversial (Brown, Pipe,
[
y Lewis, Lamb, & Orbach, 2007).
b
d The Linguistic Inquiry Word Count software program (LIWC) was used
e
ad to calculate emotional utterances in children’s narratives. LIWC has been
o
nl used widely in research (Tausczik & Pennebaker, 2010), including studies on
w
o children (Fivush et al., 2007). Because the LIWC affect dictionary contains
D
terms that may not refer to subjective states of the speaker (Bantum & Owen,
2009), we modified the dictionary to exclude words that can describe objects
rather than subjective states (e.g., cool, good), except when those words
were clearly used to describe feelings (e.g. “I felt good”).
We predicted that children in the emotional-rapport condition would
report higher percentages and numbers of emotional words in response to
Facilitating Emotional Language 181
the rapport phase and the story stem phase than children in the NICHD-
rapport condition. We expected that children would report lower percent-
ages and numbers of emotion words to negative than positive events. Lastly,
we expected that children’s responses to cued-emotion prompts would elicit
higher percentages and numbers of emotion words than other prompt types.
METHOD
4
1
0
y 2 Participants
r
a
u
r One hundred forty-two 4- to 9-year-olds (50% males) were interviewed. All
b
Fe children had been removed from parental or guardian custody due to sub-
4
0 stantiated maltreatment (e.g., physical abuse, sexual abuse, neglect). The
7
3 sample was ethnically diverse and representative of children in dependency
9:
0 court in Los Angeles (57% Latino, 25% African American, 9% Caucasian, 7%
] at biracial, 2% Asian; Quas, Wallin, Horwitz, Davis, & Lyon, 2009).
e
u
q
a
J
a Materials and Procedures
n
a
Di All study materials and procedures were approved by the Presiding Judge of
[
], the Los Angeles County Dependency Court, the agencies who work with
a
ni maltreated children, and the Institutional Review Board. Children who met
r
o
alif eligibility requirements were identified at the courthouse. Children awaiting
C adjudication or contested disposition hearings (because they might be asked
n
r to testify), children incapable of communicating to the experimenter in
e
h
ut English, and children whose attorneys objected to their participation were
o
S ineligible.
f
o
y
sit INSTRUCTIONS, ICE-BREAKER PHASE, AND RAPPORT
r
e
v
ni All children received interview instructions and an icebreaker phase mod-
U
C eled after the NICHD Protocol (Lamb et al., 2008). The experimenter taught
S
U the appropriateness of saying “I don’t know,” expressing incomprehension,
[
y correcting the interviewer, stated that she didn’t know what had happened
b
d and elicited a promise to tell the truth. The experimenter then asked children
e
ad about things they “like to do” followed by things they “do not like to do.” For
o
nl each topic, the interviewer asked a cued-action prompt (“Tell me more about
w
o [action]”; Lamb et al., 2003).
D
Children were randomly assigned to one of two rapport conditions.
Children in the emotional-rapport condition (n = 71) were asked about the
last time they felt good on the playground followed by the last time they felt
bad on the playground. Children in the NICHD-rapport condition (n = 71)
were asked about their last birthday party followed by what happened
yesterday. The initial invitation children received for each rapport topic was
182 E. C. Ahern and T. D. Lyon
“Tell me everything that happened from the very beginning to the very end.”
Children were asked about each event for 90 seconds.
Emotional language was defined as any utterance related to emotions,
including explicit emotion labels, words identifying emotional facial displays
(e.g., cry, laugh, smile), and words reflecting desires and preferences (e.g.,
like, love, hate, want; Salmon, Roncolato, & Gleitzman, 2003). Explicit emo-
tion labels included references to people (I was happy), things (It was a
4 happy movie) or events (It was sad when he left) and phrases that included
1
0 the word feel.
2
y Children in both rapport conditions received the same types of follow-up
r
a
u prompts. What-next (“What happened next?”) and cued-action (“Tell me
r
b
e more about [action]”) prompts were alternated. For every reference to
F
4 emotion or preference, experimenters followed up with a cued-emotion
0
7 prompt (“Tell me more about [emotion]”) and a what-think prompt (“What
3
9: did you think when [emotion]?”) in the subsequent conversational turn. After
0
at children responded to cued-emotion and what-think prompts, the
]
e experimenter resumed asking cued-action and what-next prompts.
u
q
a A series of structured back-up prompts was used to respond to
J
a children’s nonresponsiveness (e.g., “I don’t know”) due to the potential
n
a
Di difficulty children may have nominating emotional events (Fivush et al.,
[
], 2003). During the “like to do” and “don’t like to do” topics, back-up prompts
a
ni included (a) repetition of the initial question, (b) narrowing the topic (“Tell
r
o me about things you like to do outside”), and (c) indicating the experimenter’s
f
ali desire to know more about the child (“It’s really important to me to know
C
n about you [name]. Tell me about what you like to do”). During the rapport
r
e
h phase, the experimenter used a similar series of structured back-ups when
ut
o children were initially unresponsive: (a) focusing on actions (e.g., “[Name]
S
of what did you do the last time you felt really good on the playground?”), (b)
y
sit narrowing the topic (e.g., “[Name] tell me about the last time you felt really
er good on the playground with other kids”), and (c) indicating to children
v
ni the experimenter’s desire to know about them (e.g., “It’s really important
U
C to me to know about you [name]”). Back-up prompts are not discussed
S
U further because children virtually always responded to the initial prompts
[
y (91%).
b
d
e
d
a
o STORY ADMINISTRATION
nl
w
o Subsequent to the rapport phase, children were presented four stories. The
D
stories included two events designed to elicit positive reactions from the
protagonist (getting a present, winning a race) and two events designed to
elicit negative reactions (scraping a knee, spilling juice). The stories were
brief and contained no emotional language. All characters were racially
ambiguous and displayed no facial expressions. Positive and negative stories
were presented in an alternating order which was counterbalanced between
Facilitating Emotional Language 183
subjects. Protagonist gender was balanced across story valence. The appen-
dix shows pictures and text used for the stories.
All children received what-next, cued-action, and cued-emotion-
protagonist and what-think-protagonist prompts for every story. Following
the presentation of each story, children were asked an initial what-next
prompt. After the initial what-next prompt, children were asked one follow-up
what-next prompt, two cued-action prompts, up to three cued-emotion
4 prompts and one what-think prompt. Children who did not mention
1
0 protagonist emotion to what-next and cued-action prompts were asked how-
2
y feel prompts (“How did [protagonist] feel when [climax of story]?”). All
r
a
u children were asked cued-emotion and what-think prompts about the
r
b
e protagonist. Children received up to two additional cued-emotion prompts
F
4 when they mentioned explicit emotion labels or preferential language to the
0
7 what-next and cued-action prompts. If there were multiple emotional
3
9: utterances, interviewers followed up on explicit emotion label utterances
0
at first and preferential language second.
]
e
u
q
a
a J EXPERIMENTER TRAINING
n
a
Di Interviewers were trained to followup on explicit emotion labels, “feel x”
[
], phrases, and preferential language (“like”, “hate”, “love”, “want”). Interviewers
a
ni were provided scripts that included language for prompts and examples of
r
o words that would require cued-emotion prompts to be administered. During
f
ali pilot testing and initial study administration, the first author met with inter-
C
n viewers weekly to review videotapes and ensure adherence to the script.
r
e
h
ut
o
f S TRANSCRIBING
o
y
sit Children’s interactions with the interviewer were videotaped and tran-
er scribed. Each transcript was verified by a second transcriber to ensure
v
ni accuracy. Noninformative utterances (stutters, filler words such as “yeah”, “uh”)
U
C were removed from transcripts prior to coding (Poole & Dickinson, 2000).
S
U
[
y
b CODING
d
e
ad Interrater reliability was established for the development of the modified
o
nl LIWC affect dictionary. Twenty percent of the original dictionary words were
w
o independently coded by two undergraduate coders as either subjective or
D
not subjective, and their percentage agreement was .89. Creation of the
Modified LIWC Affect Dictionary allowed for computer coding. The number
of emotion words children uttered was the sum of the number of words
children produced identified in the Modified LIWC Affect Dictionary, “like”
utterances reflecting preference, and words not identified in the Modified
LIWC Affect Dictionary that were linked with “feel” (“I felt good”). Because